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Op-Ed: Big Pharmacies Should Stamp Out Cigarette Sales

Virtually every major pharmacy chain markets itself as a source for community health care. Yet, many of the very same drug stores where sick Americans go to get well also sell toxic tobacco products.

Every year, cigarettes kill more than 480,000 Americans — more than alcohol, illegal drug use, car accidents and firearm-related deaths combined. Smoking causes heart disease and emphysema, increases the risk of stroke, and is the primary cause of lung cancer.

Recently, the attorneys general of 28 states and territories sent letters to the chief executives of Kroger, Rite-Aid, Safeway, Wal-Mart and Walgreens — which also owns the Duane Reade chain — asking them to remove tobacco products from their shelves and put customers' health ahead of potential profit. We were asking them to follow the lead of one of their competitors, CVS Caremark, which earlier this month took this important step.

Inherent conflict

Yes, eliminating cigarette sales will cut into profits — but CVS' management had a different formula in mind.

According to the company's own annual report, a significant portion of CVS' revenue comes from reimbursements from government-sponsored health-care programs, including Medicaid and Medicare. As their states' chief law enforcement officers, attorneys general have oversight of those reimbursements — as well as enforcement authority over consumer-protection provisions of the landmark 1998 Tobacco Master Settlement Agreement.

The corporate managers at CVS foresaw an inherent conflict: that providing government-funded prescription reimbursements to companies whose business practices further the nation's leading cause of preventable deaths could violate state laws — and that if state attorneys general ruled in that direction, it could jeopardize a very valuable revenue stream.

Selling cigarettes at pharmacies also contradicts the intent of the Master Settlement Agreement, which the major tobacco companies signed with the attorneys general of 46 states — that smoking, particularly by young people, is a national crisis and needs to be reduced. That is why the 1998 agreement is supposed to provide resources to programs to prevent youth smoking.

Candy, toothpaste, smokes

Yet, in pharmacies that sell tobacco products, children buying candy or gum are confronted with eye-catching cigarette displays right behind the checkout counter. This puts temptation easily within sight, but just out of reach — in a country where 90 percent of adult smokers start before age 18. And customers who are trying to quit smoking — a difficult task, attained by just 4 percent of smokers who try — have to pay for their smoking-cessation products while staring at rows upon rows of cigarette packs.

This sends a dangerous mixed message — that far from being a hazard, cigarettes are simply a routine part of life, like toothpaste, aspirin and Band-Aids.

Since the 1998 settlement was signed, the New York attorney general's office has taken a strong enforcement role, suing several major tobacco companies for violating the agreement, sponsoring legislation at the state level to ban ads aimed at children and working at the national level to empower states to restrict all tobacco advertising.

Seeking voluntary compliance from major pharmacy chains in helping to protect their customers — especially young people — from highly addictive, highly toxic tobacco products is in keeping with the mandate of every attorney general to work to reduce tobacco use and protect public health. It is time for CVS' primary competitors to step up and follow its lead, becoming responsible corporate citizens and acknowledging the important role they can play in reducing the availability of tobacco products — and the harm they do.

Americans rely on their local drug stores to provide them with lifesaving medicines. These pharmacy chains should be promoting public health — not selling toxic substances that cut life short.